Life on the Societal Fringe: Marginalization & HIV

Wilhelm Cortez on a few ways we marginalize others, and the devastating impact this can have on individuals and societies.

“What people do and what they experience affects their mental health. Substance use and abuse, discrimination, marginalization and poverty are all factors that impact mental health and, in turn, can place people at risk for HIV infection.” –Jim Dilley, MD, Pamela Decarlo, How Does Mental Health Affect HIV Prevention?

When a portion of society is marginalized, that population, in order to satisfy the instinctual need to survive, must at times turn to the fringes of society. This usually is not a safe option due to crime, exploitation and the others forms of abuse that feed upon the fringes. Add to this the mental health issues that come along with marginalization, and the risk factor increases greatly.

Certain cultures and societies have been traditionally closed to other gender concepts. This inability to accept human gender diversity forces other gender concepts and individuals to the fringes of our society, as well as to the fringes of the social mind. When pushed to the fringe, many other aspects of an individual’s mental health can also be at risk. And these mental imbalances can lead to high risk behavior.

“Male-to-female transgender persons (MTFs) identify low self-esteem, depression, feelings of isolation, rejection and powerlessness as barriers to HIV risk reduction. For example, many MTFs state that they engage in unprotected sex because it validates their female gender identity and boosts their self-esteem.” –Jim Dilley, MD, Pamela Decarlo, How Does Mental Health Affect HIV Prevention?

The marginalized group might still reside in the physical society, but in the actual social interactions of the society the individual is cut out, self esteem plummets and high-risk behavior emerges.